Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Tu.D.2951 - Tu.D.2956

Tuesday July 9, 1996

Results: Respondernts from virtually every Canadian city with an organized or identifiable
gay and/or bisexual community participated in this Research Needs Assessment (N=33). All
responder ts reported using HIV prevention research results in their work, and many had
prag it,j,,estions for the irprovement of such research. I n the ranking of issues, specific health ri cmr uity development concer ns cleary took precedence over HIV preventioen rand ed, aon research. Importantly, responses were polarized both by community size
and Ioc: Sn r naler, less urban communities ranked elements of community development
as most importarnt, whereas larger more urban communities prioritized aspects of care,
education and prevention.
Conclusions: The discrepancy between the reported use and value of HIV prevention
research in the acivites of service organirzations and the ranking of research relative to
other soca, polical and economic facitors higghlight he continued complexity of conducting
HIV prevention research and evaluation amongst populations of men who have sex with
men. Rese nch itr, rtgi e rr ut co into inetbala nce e ogol and needs of affected communities, seri e or i rizations, fundingagencies and the research enterprise.
Dan A tman, 1 i en' Park Cres. W, 3rd Floor Toronto, Ontario. M5S I A8 Canada Tel:
S16 978-18 30 97/ 2704 emrail: dan allman(l)utoronto.ca
Tu.D.295 I
GAY'S DIFFICULTIES IN CHANGING SEXUAL BEHAVIOUR: SELF-ESTEEM OR LACK
OF FUTURE
Le Clerc, R o. Gaty And Lesbian Center COCQ SIDA. Montreal, Quebec.
Issue: Gay,, resistence to change their sexual behaviour because of a lack of the sense
of their utiity in the society.
Project: 5 mt etin, t,i r0 non activist gays in tree groups. Non directive discussion on
Family A IDS, I onliness, Gay Culture and Project for life. In prevention, we face resistence to
sexual erIis,, ihange because of what we thought was low self-esteem.The project
wanted to d us, (r, that issue with gays who were non erngaged in Gay groups or in AIDS
groups Silent gays.
Results: Ve discovered that self esteem was the extorisation of a more deep problem: lack
of future sen nd utilityGays feel useless for the society because of the non recognition
of their love, ther sense of life. Gays work mainly in "services to confirm their utlity in the
socety
Lessons Learned: we have t o question the way we plan prevention in the gay community
We Iave to dtiscuss about that issue of recognition of gays.
Roger Le Clerc,45144 Berri, Montreal, 121 2R3,Te:[phone]
Tu.D.2952
WORKING TOWARDS A SOUTH AFRICAN GAY AND LESBIAN DEVELOPMENT
MODEL FOR HIV/AIDS/STD INTERVENTION IN AFRICAN TOWNSHIPS
Griffin, G., Stein, N. AIDS Support and Education Trust, Cape Town, South Africa.
Issue: Western, vertical AIDS/S TD programnmes are ineffective and inappropnriate in South
African township settings. Black gays and lesbians have also traditionally been excluded from
such prevention and care initiatives It s now essential to investigate appropriate models of
intervention within a context of social development.
Project: ASET in Cape Town, with a long history of positive interventions with city based
gays aid esh s, recognised that vertical AIDS programmes are inappropriate because of
the lark of supportive health and other social infrastructures. As a result of the long history
of apartheid, it was acknowledged that very little was known about the needs of gays and
lesbians Ilving in the townships. In 1995 an initial pilot study was conducted to investigate
these needs. 3II people parcipated in the survey where a questionnaire was administered.
This qualiatliv research was used to inform and develop an intervention pro grarmme to be
put in place in 1996
Results: A need for specific interveneons aimed at township gays and lesbians was identifed and valuable demographic information about the community was obtained. Amongst
the towrshp sample, the demand for nformation and workshops was significantly higher
than the overall smpie. Ths sample was also signifioeantly more worried about HIV/AIDS
and felt they did not know enough about safer sex.This initia pilot study highlighted the
need to devel:p t he trownship tay and lesbian conrnunity to create a strong support network which co ld the-n carry suetainable HIV/AIDS/STD intervention prograrmmes. I t thus
irforrd AS[f of its future direction with the township programme and areas which need
further invest 'attn.
N. Sten, fO. f a 138, Salt Rover, South Africa, 7924.Tel:[phone](w) 021 -452
44 (h) I[,x: 02tf4f84089.
Tu.D.2953
HIV/AIDS TRANSGENDER SUPPORT GROUP: IMPROVING CARE DELIVERY AND
CREATING A COMMUNITY
Grimald lam PM. Jacobs, J. The Center for Special Studies, New York Hospital Cornell
Medical Center NY(, NY I SA
Issues: Cr ansyendeir patents treited it o r it-oe urban HIV/AIDS pritrary care ctnic pre
sented with poor recods of medical compliance and stited feelins of isolation and dis
or i nittii A sripipiort group as developed to address the need of this unique popula
Project: The IHIV trarspender support yroup recruited reale to female pre operatie transea erts who were soaa!1 and emotionally isolated, and some of whom were
sex workers c he It roup provided a safe envionment for patients to give mutual support,
develop comm nication skils, and address concerns of prejudice.The group educated each
other or safer sex, ch lenes of condom use, and the risk of physical violence from sex
custome he group lertder created a supportive environment for patients, who had experienced iibairdonme nt and rejection ftom family.
Results: The HIV transgender group met 83 sessions and involved 12 members throughout
the course of 2 years. Group members initially were unable to help one another due to
their frustration wth societal pr-judice.The group leader assumed an active role to foster
careg rig and coitmun iation skills.Transsexual p, ients' stated a dramatic increase in trust
for thei- health care providers over the 2 years.The number of clinic appointments missed
by all group rember s decreased from 64 in 1994 to 12% in 1995.The group developed
their own cortunity within the elnit, shared HIV and transgender information, provided

mututl support, and fought discrimination Universeiconcert i'sd i-ntfiLd b th i rop
included: the effort to maintain female physical appearance du r'g HIV rllne -oatieso
the challenge of condom use to female self perception; and theprotecto tone's
selection during hospitalization and fune al irr-ngerents. he group m bers rete -
videotape of their stories in order to educate health care provi ers on their needs n d in
order to reach out to isolated transsexuals in the communty.
Lessons Learned: A formerly isolated noncompiiantttuIgroupiits f - p snt,., r, ato - rate a community of strength and support through a cti6ely 'seasitve suplor: gro;p. 1tis
increased their medical compliance and enhanced their self-teem.
James Grirmaldi, The NewYork Hospital. Center for Spec a iStud es. 5>5 Ea- Cr-ht Street
New York, NY USA 10021 Telephone: [phone]t 5 Fx: (21 - 8.11
Tu.D.2954
AN ETHNOGRAPHIC STUDY OF HIV INFECTED MALE-TO-FEMALE TRANSGENDERED CLIENTS
Marsha.Bennett MN, RN, DNS Candidate. Louisan Stte e Unr versity M edl Center HIV
Section and Harlee S. Kutzen, BSN, RN, L.SUMC IV Scnto
Objective: o des ribe the psychosocial and heaoth care need fe IV nf eri e t
female transgendered patient attending a public HtV ir bu-,tor/prit; r i lvnMethods: Participants, aged 18 years and older were refered im their prrie,,
providers. Ethnographic interviews were conducted foc rsing orn IV healt[ 'f, t''I
gender history, surgical and hormonal treatments, and oncerns r ia ctS wh,-r..
primary care through the public HIV armbulatory care clin. Irntervews were ar otrper,
transcribed verbatim, and analyzed using a coputer qualitarv ti irnals pror irt,
NUDIST Maor themes were generated and suitetes explred vi, NU t IS's i
cal branching schema.
Results: Maintaining the iusion of be Ing a feac throu t h tI CiiL mproc c "fp:
a femrale emerged as a core theme. One mechanism that supported passrg wts the:,
nition of self and the acknowledgment of the redefined selfs Ytierinclu t helth,
providers. Conditions that threatened the success of pas no and threatened.con pt
were: I) being marginalized and 2) an indifferent r ho tI. eat I,re sy 'e S c
questioned whether health care providers knewviorir e ll to suppt theirit i '
hormone and psychosocial needs.
Conclusions: Male-tof emale transgendered HIV positive cilent have barrers to a s r
care because of their marginalized status. Prmrare fo t po on needs tncde
staff education and desensitization aihou t gender issues. Im - ions for rr-r,- and sitr
care providers are addressed.
Marsha J. Bennett, MN, RN, DNS Candidate, LSUMC H1-V Secto 136 Sotho iman Str-et.
New Orleans, LA 70112 USAVoice: 504-568 7890: Fax: [phone]
Tu.D.2955
GAY CITY:AN HIV PREVENTION COMMUNITY MOBILIZATION FOR GAY AND
BISEXUAL MEN
Leonard, John C, Barr B,Welch Q. Rettenmaer J. Gay City 1iealth Proiect, Seattle
Washington, USA
Issue: Gay and bisexual rer continue to be at high risk for HIV infection dep iexteri e
AIDS information and safe sex education carmpaigns.
Project: A series of community forums for gay and b isexual men was produced. Fo run
topics were generated by community surveys and focused on a rarnge of issues related to
HIV prevention and community health (e.., datn, coming ou, HIV serostaus, o sex,
grief and loss). i-he talk show style forums were hosted by oco opinion Iader, includin a
prominent drag performe. Aggressve outreach, markeing, and public relinors strategies
were utilized to promote the events. AIDS and gay comrnun r ty groups were nvied to staff
information booths at each event, and participant surveys/evalations were i dmirstered.
Results: Each Gay City forumn ha,, attracted standing room ony crowds cer 30Ca
and bisexual men.We've seen a 35% decrease in reported unprrotected anal ex ont
forumr participants, and substan ital increases n participants' feelings of gay pride and conection to the gay community There is also a diffusion effectotot he forum's Ivepovoctive discussion. Participants report discussing issues raised it the forum with ivera of
eight others in the weeks after the event. 150 volunteers have been recruit ed fo e
forums and seve-ral new HIV prevention and gay comunity budingr profects e rowr
out of the forums, ncludirng the area 's first support r ap fo I IV reatv Oarner
Lessons Learned: Culturallyreevnt, c t ommunitny bed cInterven ctons whchit e prie
ally marketed can reach large numbers of high risk enda i 1s, ibddpn coare nity, ielf
esteem, and reducing HIV rsk behavior
JC Leonard, 20 Harvard Avenue East, Seattle, Washinon, USA, 98 102Telephor 206
860 6969 Fax: [phone], e nuil: aytyaol.com
Tu.D.2956
VOICES FROM THE FRONT:THE CONSEQUENCES OF AIDS-RELATED LOSS ON SIX
HIV-NEGATIVE GAY MEN LIVING IN NEW YORK CITY
Kellerhouse Bruce New York liversit- New York, NY USA
Objective:To de-ibe the present-day Infe oncerns of I s l Oip of H nea e
men affected by continuous, nmultiple bereavements due to AIDS
Method: Participants were six HIVinegtve gay men, ages f- to.htn who had inlet
or more losses due to AIDS. Data were collected b conductun intensive ntervlews. Audio
tape transcriptions, anaytic memos, and observer reflecions compnrsed the data. Data were
analyzed inductively usin principes of ronded the a i tt r o inn
late thematic categories to dec'ibe the phen itenor urier studIs
Results: Analysis of the dita reveled a coaescing of hermes iround nine d reet to
gories: Loss, Shated Experience, Care giviag, D evinI Coping, Present[ry r u-mt ie
Future, Making Sense, and Benefits/Gains. Resuls suto gesed ttt these nert were expenrenIng multiple losses of peers and changes in lifestyle. Mostnt ovewheed by ti e
i/ng responsibiities.Their gevin processes were complicated b cnt l T
were employing unique copng strateg es to fight battle in.hich they old be:on
casualty Experie ces of traueatic amnesia were commo rIhey wantedo t f tceir con
nections with AiS and build new social networks. A future without AIS was di
envision.They s- ugled to make sense of AIDS and to hrd min in ther o s and pan.

421